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ACL reconstruction is a procedure in which a damaged anterior cruciate ligament is replaced. The replacement graft comes from a hamstring tendon, patellar tendon, or an allograft. This surgery is usually recommended when other treatments, such as medication or physical therapy, do not relieve symptoms. A successful reconstruction surgery usually improves the sensations of an unstable knee and prevents your knee from giving out.

What Is ACL Reconstruction?

An ACL, or anterior cruciate ligament, reconstruction is a surgery that is used to removed a damaged anterior cruciate ligament and replace it with an ACL graft. ACL reconstruction is one treatment option for a torn ACL.

Understanding a Torn ACL

The bones that make up the knee are:
  • The femur (or thighbone)
  • The tibia (or shinbone)
  • The patella (or kneecap).
Ligaments, which are bands of tough fibers, hold these bones together. Inside the knee, two ligaments hold the thighbone to the shinbone. The first is the anterior cruciate ligament, or ACL. This is especially important in running and other athletic activities. Its function is to keep the shinbone from sliding forward while you are moving. The second is the posterior cruciate ligament, or PCL. It keeps the thighbone from sliding forward during knee motion.
The ACL can be injured or torn in a number of ways. The most common way is a sudden pivoting or cutting maneuver done during a sporting activity. At the time of the injury, a "pop" or "snap" can sometimes be felt or heard.
When the ACL is torn, the shinbone is able to slide forward, which causes the knee to "give out" or be unstable. In an abnormal position, other structures in the knee can be damaged, especially when the knee bends. For example, your meniscus can tear due to the additional force against it. If your meniscus tears or becomes damaged, the pressure between the shinbone and thighbone is increased. This increase in pressure will speed up the wear and tear on the cartilage and can lead to arthritis.
Once an ACL tear is suspected, possible treatments include:
  • Medication
  • Changes in activity level
  • Physical therapy.
If these treatments are not successful, an ACL reconstruction may be recommended.
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
Last updated/reviewed:
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